License Verification

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LAURIE LEBLANC DAIGLE

License Number: PA9107203

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9107203
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
05/01/2013
Address of Record
1394 E John Sims Pkwy
NICEVILLE, FL 32578
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
ARBUCKLE, SEAN SR Supervising Prescribing Practitioner Osteopathic Physician 11132 08/07/2019
BORUP, MIKEL ELIAS Supervising Prescribing Practitioner Osteopathic Physician 16398 02/20/2020
GAILMARD, WILLIAM ROBERT Supervising Prescribing Practitioner Medical Doctor 138184 08/07/2019
HART, MARY FRANCES MD Supervising Prescribing Practitioner Medical Doctor 84276 01/31/2022
LATHAM, JOSHUA LUKE DO Supervising Prescribing Practitioner Osteopathic Physician 10027 03/08/2018
PORTER, JAYCE Supervising Prescribing Practitioner Osteopathic Physician 16341 01/08/2020
RAK, TIMOTHY AARON Supervising Prescribing Practitioner Medical Doctor 83486 01/28/2020
REVILLA, RICARDO ARSENIO Supervising Prescribing Practitioner Medical Doctor 106166 02/20/2020
THOMPSON, TOMMY GLEN II Supervising Prescribing Practitioner Medical Doctor 128635 07/25/2017

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.